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Bone mineral density and turnover in patients with acromegaly in relation to sex, disease activity, and gonadal function

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Abstract

Acromegaly is a rare disease caused by growth hormone (GH) hypersecretion. GH and insulin-like growth factor-I (IGF-I) exert anabolic activity in bones. Nevertheless, bone mineral density (BMD) loss is not uncommon in patients with acromegaly. It is assumed to be due to hypogonadism associated with the acromegaly. The aim of the study was to examine BMD at various skeletal sites and bone turnover and to assess the influence of impaired gonadal function and disease activity on BMD and turnover changes in acromegaly. A total of 62 patients were studied (40 women, 22 men). Among the women, 22 had active disease and 18 were cured; 16 women had normal gonadal function, and 24 were hypogonadal. Altogether, 12 men presented with active acromegaly, and 10 were cured; normal gonadal function was found in 10 men, and hypogonadism was diagnosed in 12 men. Controls were 30 healthy subjects. Densitometry using dual-energy X-ray absorptiometry of the lumbar spine, proximal femur, forearm, and total body was carried out. Bone turnover was studied based on serum osteocalcin, C-terminal collagen type 1 crosslinks, and bone alkaline phosphatase concentration. A disadvantageous effect of acromegaly on bone density was associated with hypogonadism in the distal radius (in women), the proximal femur (in men), and the total body (both sexes). An anabolic effect of GH during active acromegaly was present in the proximal femur only in men. We confirmed increased bone turnover in the presence of acromegaly, and these changes were similar regarding the activity of the disease and the gonadal status.

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References

  1. PJ Ho LM Fig AL Barkan B Shapiro (1992) ArticleTitleBone mineral density of the axial skeleton in acromegaly J Nucl Med 33 1608–1612 Occurrence Handle1517833 Occurrence Handle1:STN:280:DyaK38zovFSgsw%3D%3D

    PubMed  CAS  Google Scholar 

  2. F Jockenhovel S Rohrbach S Deggerich D Reinwein C Reiners (1996) ArticleTitleDifferential presentation of cortical and trabecular peripheral bone mineral density in acromegaly Eur J Med Res 1 377–382 Occurrence Handle9360937 Occurrence Handle1:STN:280:DyaK1c%2FjtVKntg%3D%3D

    PubMed  CAS  Google Scholar 

  3. T Diamond L Nery S Posen (1989) ArticleTitleSpinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism Ann Intern Med 111 567–573 Occurrence Handle2774387 Occurrence Handle1:STN:280:DyaL1Mznt1Cqug%3D%3D

    PubMed  CAS  Google Scholar 

  4. A Scillitani I Chiodini V Carnevale GM Giannatempo V Frusciante M Villella M Pileri G Guglielmi A Di Giorgio S Modoni S Fusilli A Di Cerbo A Liuzzi (1997) ArticleTitleSkeletal involvement in female acromegalic subjects: the effects of growth hormone excess in amenorrheal and menstruating patients J Bone Miner Res 12 1729–1736 Occurrence Handle9333135 Occurrence Handle1:STN:280:DyaK2svnt1altw%3D%3D

    PubMed  CAS  Google Scholar 

  5. I Chiodini V Trischitta V Carnevale A Liuzzi A Scillitani (2001) ArticleTitleBone mineral density in acromegaly: does growth hormone excess protect against osteoporosis? J Endocrinol Invest 24 288–291 Occurrence Handle11383916 Occurrence Handle1:STN:280:DC%2BD3MzhtV2hug%3D%3D

    PubMed  CAS  Google Scholar 

  6. GP Lesse WD Fraser R Farquharson L Hipkin JP Vora (1998) ArticleTitleGonadal status is an important determinant of bone density in acromegaly Clin Endocrinol (Oxf) 48 59–65 Occurrence Handle10.1046/j.1365-2265.1998.00349.x Occurrence Handle1:STN:280:DyaK1c7mvFyjtg%3D%3D

    Article  CAS  Google Scholar 

  7. S Ezzat S Melmed D Endres DR Eyre FR Singer (1993) ArticleTitleBiochemical assessment of bone formation and resorption in acromegaly J Clin Endocrinol Metab 76 1452–1457 Occurrence Handle8501150 Occurrence Handle10.1210/jc.76.6.1452 Occurrence Handle1:STN:280:DyaK3s3ntlygsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. M Bolanowski D Jędrzejuk A Milewicz A Arkowska (2002) ArticleTitleQuantitative ultrasound of the heel and some parameters of bone turnover in patients with acromegaly Osteoporos Int 13 303–308 Occurrence Handle12030545 Occurrence Handle10.1007/s001980200030 Occurrence Handle1:STN:280:DC%2BD383ptVCisw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. A Colao S Cannavo P Marzullo R Pivonello S Squadrito G Vallone B Almoto E Bichisao F Trimarchi G Lombardi (2003) ArticleTitleTwelve months of treatment with octreotide-LAR reduces joint thickness in acromegaly Eur J Endocrinol 148 31–38 Occurrence Handle12534355 Occurrence Handle1:CAS:528:DC%2BD3sXptVKmsg%3D%3D

    PubMed  CAS  Google Scholar 

  10. C Ohlsson B-A Bengtsson O Isaksson TT Andreassen MC Slootweg (1998) ArticleTitleGrowth hormone and bone Endocr Rev 19 55–79 Occurrence Handle9494780 Occurrence Handle10.1210/er.19.1.55 Occurrence Handle1:CAS:528:DyaK1cXhtlagtL8%3D

    Article  PubMed  CAS  Google Scholar 

  11. M Bolanowski W Wielgus A Milewicz R Marciniak (2000) ArticleTitleAxial bone mineral density in patients with acromegaly Acad Radiol 7 592–594 Occurrence Handle10952108 Occurrence Handle10.1016/S1076-6332(00)80573-5 Occurrence Handle1:STN:280:DC%2BD3M7gvFWhtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. A Scillitani C Battista I Chiodini V Carnevale S Fusilli E Ciccarelli M Terzolo G Oppizzi M Arosio M Gasperi G Arnaldi A Colao R Baldelli MR Ghiggi D Gaia C Di Somma V Trischitta A Liuzzi (2003) ArticleTitleBone mineral density in acromegaly: the effect of sex, disease activity and gonadal status Clin Endocrinol (Oxf) 58 725–731 Occurrence Handle10.1046/j.1365-2265.2003.01777.x Occurrence Handle1:CAS:528:DC%2BD3sXlt12hur4%3D

    Article  CAS  Google Scholar 

  13. JA Kanis (1997) Osteoporosis Blackwell Healthcare Communications London 114–147

    Google Scholar 

  14. MJ Kayath JGH Vieira (1997) ArticleTitleOsteopenia occurs in a minority of patients with acromegaly and is predominant in the spine Osteoporos Int 7 226–230 Occurrence Handle9205635 Occurrence Handle10.1007/BF01622293 Occurrence Handle1:STN:280:DyaK2szkvFOitg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. S Longobardi C Di Somma F Di Rella N Angelillo D Ferone A Colao B Merola G Lombardi (1998) ArticleTitleBone mineral density and circulating cytokines in patients with acromegaly J Endocrinol Invest 21 688–693 Occurrence Handle9854685 Occurrence Handle1:STN:280:DyaK1M%2FntFynuw%3D%3D

    PubMed  CAS  Google Scholar 

  16. H Kaji T Sugimoto D Nakaoka Y Okimura H Kaji H Abe K Chihara (2001) ArticleTitleBone metabolism and body composition in Japanese patients with active acromegaly Clin Endocrinol (Oxf) 55 175–181 Occurrence Handle10.1046/j.1365-2265.2001.01280.x Occurrence Handle1:STN:280:DC%2BD3MvovFCmsw%3D%3D

    Article  CAS  Google Scholar 

  17. H Kotzmann P Bernecker P Hubsch P Pietschmann W Woloszczuk T Svoboda G Geyer A Luger (1993) ArticleTitleBone mineral density and parameters of bone metabolism in patients with acromegaly J Bone Miner Res 8 459–465 Occurrence Handle8475795 Occurrence Handle1:STN:280:DyaK3s3jsFOjsw%3D%3D Occurrence Handle10.1002/jbmr.5650080410

    Article  PubMed  CAS  Google Scholar 

  18. A Colao M De Rosa R Pivonello A Balestrieri P Cappabianca A Di Sarno V Rochira C Carani G Lombardi (2002) ArticleTitleShort-term suppression of GH and IGF-1 levels improves gonadal function and sperm parameters in men with acromegaly J Clin Endocrinol Metab 87 4193–4197 Occurrence Handle12213870 Occurrence Handle1:CAS:528:DC%2BD38XntFOls78%3D

    PubMed  CAS  Google Scholar 

  19. I Morimoto K Kai Y Okada N Okimoto K Uriu K Akino S Yamashita T Nakamura S Eto (2000) ArticleTitleSkeletal changes in rats bearing mammosomatotrophic pituitary tumors: a model of acromegaly with gonadal dysfunction Bone 26 255–261 Occurrence Handle10709998 Occurrence Handle10.1016/S8756-3282(99)00274-4 Occurrence Handle1:CAS:528:DC%2BD3cXhtFalsrg%3D

    Article  PubMed  CAS  Google Scholar 

  20. M Marazuela B Astigarraga MJ Tabuenca J Estrada F Marin T Lucas (1993) ArticleTitleSerum bone gla protein as a marker of bone turnover in acromegaly Calcif Tissue Int 52 419–421 Occurrence Handle8369987 Occurrence Handle10.1007/BF00571329 Occurrence Handle1:STN:280:DyaK3sznvF2juw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. A Piovesan M Terzolo G Reimondo A Pia A Codegone G Osella A Boccuzzi P Paccotti A Angeli (1994) ArticleTitleBiochemical markers of bone and collagen turnover in acromegaly or Cushing's syndrome Horm Metab Res 26 234–237 Occurrence Handle8076906 Occurrence Handle1:CAS:528:DyaK2cXkvVSju70%3D Occurrence Handle10.1055/s-2007-1001672

    Article  PubMed  CAS  Google Scholar 

  22. P Legovini E De Menis F Breda D Billeci A Carteri P Pavan N Conte (1997) ArticleTitleLong-term effects of octreotide on markers of bone metabolism in acromegaly: evidence of increased serum parathormone concentrations J Endocrinol Invest 20 434–438 Occurrence Handle9364245 Occurrence Handle1:CAS:528:DyaK2sXntlGhtLo%3D

    PubMed  CAS  Google Scholar 

  23. FP Cantatore G Loverro AM Ingrosso R Lacanna E Sassanelli L Salvaggi M Carrozzo (1995) ArticleTitleEffect of oestrogen replacement on bone metabolism and cytokines in surgical menopause Clin Rheumatol 14 157–160 Occurrence Handle7789055 Occurrence Handle1:STN:280:DyaK2MzgvV2jsw%3D%3D

    PubMed  CAS  Google Scholar 

  24. ES Orwoll RF Klein (1995) ArticleTitleOsteoporosis in men Endocr Rev 16 87–116 Occurrence Handle7758434 Occurrence Handle10.1210/er.16.1.87 Occurrence Handle1:CAS:528:DyaK2MXltlKhu7c%3D

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology and Diabetology, Wrocław Medical University, 4 Pasteura Street, 50-367, Wrocław, Poland

    Marek Bolanowski, Jacek Daroszewski, Marek Mędraś & Beata Zadrożna-Śliwka

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  1. Marek Bolanowski
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  2. Jacek Daroszewski
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  3. Marek Mędraś
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  4. Beata Zadrożna-Śliwka
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Correspondence to Marek Bolanowski.

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Bolanowski, M., Daroszewski, J., Mędraś, M. et al. Bone mineral density and turnover in patients with acromegaly in relation to sex, disease activity, and gonadal function. J Bone Miner Metab 24, 72–78 (2006). https://doi.org/10.1007/s00774-005-0649-9

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  • DOI: https://doi.org/10.1007/s00774-005-0649-9

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